Individual
JEAN R PHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1450 HIGHLAND AVE, NEEDHAM, MA 02492-2690
(781) 449-0020
(781) 449-3181
Mailing address
1450 HIGHLAND AVE, NEEDHAM, MA 02492-2690
(781) 449-0020
(781) 449-3181
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
57337
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057337
TUFTS HEALTH PLAN ID
MA
05
—
3024512
—
MA
01
—
693126
HARVARD PILGRIM ID
MA
01
—
J06766
BLUE CROSS ID
MA
Enumeration date
03/01/2006
Last updated
02/24/2012
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